Clinical Nurse Care Coordinator
Alliance Healthcare Solutions - Twinsburg, OH

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POSITION PURPOSE: The Clinical Nurse Care Coordinator is responsible for supporting the clinical functions of the company in accordance with the company's policies and practices. This position will be responsible for performing Comprehensive Medication Reviews (CMR) for members enrolled in the Medication Therapy Management (MTM) program and discussing patient safety and adherence concerns with identified members during the CMR while maintaining the exceptional level of
professionalism and customer service standards that Envision has attained within the pharmacy benefit management industry. This position reports to the Pharmacy Manager Clinical Programs and has no direct reports.

Temporary position until 12/31/2013. Pay rate up to $28.00/Hour

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Examine clinical programs information to identify members for specific clinical interventions by
utilizing established screening criteria
Perform telephonic CMRs with members
Deliver all required information, intervention, and member communication in timely manner;
track and log appropriately
Assist in developing statewide and national clinical programs, and supporting utilization
management
Analyze drug usage reports to identify problems and recommend solutions
Provide clinical drug information and recommendations to appropriate committees
Develop strategies to decrease pharmacy costs for members and the company
Promote companys clinical programs and resources
Facilitate member clinical program engagement
Support quality improvement programs

QUALIFICATIONS:
Bachelors degree strongly preferred
Active RN license in good standing, without restrictions in the State of CA, FL or OH
Minimum 2 to 5 years experience in a clinical setting
A knowledgeable individual with appropriate industry experience, preferably in the healthcare,
insurance or PBM industry
Previous experience in case management/disease management, as well as utilization management
Telephonic case management experience preferred
Demonstrated understanding of clinical programs
Medicare Part D knowledge strongly preferred
Strong data analysis and presentation skills
Pharmacy claim analysis experience preferred
Project management experience preferred
Ability to exercise considerable judgment, maintain confidentiality, and act in a diplomatic
manner
Bilingual in English and Spanish advantageous
Ability to independently identify, research and resolve issues
Effective verbal and written communication skills
A decisive individual who possesses a detail oriented perspective
Sound technical skills, analytical ability, good judgment, and strong operational focus
Ability to work with peers in a team effort
Demonstrated ability to manage multiple priorities and deadlines
A well-organized and self-directed individual who is able to work with minimal amount of
supervision
Capability to efficiently complete tasks in a fast paced environment
Ability to work extended hours, weekends, and holidays pursuant with industry demands
Proficient in Microsoft Office and industry related software programsLearn more about Clinical Nurse Care Coordinator